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March 13, 2020

CMS Limits Survey Activities Due to Coronavirus

This Alert is brought to you by AHLA’s Regulation, Accreditation, and Payment Practice Group.
  • March 13, 2020
  • Clint Nichols , Hancock Daniel
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In response to the ongoing threat of the 2019 Novel Coronavirus (COVID-19), the Centers for Medicare and Medicaid Services (CMS) issued a series of guidance memos. In one memo, CMS advised that, in an effort to ensure health care facilities are prepared for the COVID-19 threat, it is immediately suspending certain survey activities and provided a list of limited survey activity that will continue. According to the memo (Ref: QSO-20-12-All), survey activity is limited to the following, in priority order:

  1. All immediate jeopardy complaints and allegations of abuse and neglect;
  2. Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses;
  3. Statutorily required recertification surveys (nursing home, home health, hospice, and ICF/IID facilities);
  4. Any revisits necessary to resolve current enforcement actions;
  5. Initial certifications;
  6. Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years;
  7. Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.

CMS states that, by prioritizing the above list and discontinuing lower priority survey activities, inspectors and providers can focus on addressing the spread of COVID-19. The suspension period will last until further notice from CMS.

Because of the evolving nature of the COVID-19 threat, CMS advises that it will update frequently asked questions (FAQs) regarding the survey suspension. The FAQs provide additional detail and guidance to supplement the brief memo discussed above. Specifically, though the memo is directed to State Survey Agencies, "CMS is requesting that accrediting organizations (AOs) with CMS-approved programs follow the same guidance" that is provided in the memo. Also, though CMS has suspended certain survey activities, it is not suspending the requirement that surveys are unannounced, regardless of whether or not a facility may have any present COVID-19 issues. Further, there will be no penalty for accredited providers' or suppliers' inability to complete a reaccreditation survey before the end of 36 months, and there will be a catch up period once the suspension period has ended. Additionally, validation surveys by SAs of facilities participating in Medicare via accreditation are suspended.

While the survey priorities have been revised to focus on the most serious concerns of health and safety, it is important to note that certain survey activity will continue. First, CMS is unable to postpone statutorily required surveys with specific timeframes for completion. Second, for pending enforcement matters originating prior to the announcement, CMS will continue any follow-up actions. Third, in an effort to allow the continued expansion of health care capacity, initial surveys will continue. It is important to note that CLIA surveys are not impacted by the survey suspension.

Providers and their counsel should pay close attention to further communications and directives from CMS as the situation with COVID-19 develops.   

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